Ver el código de «Rho(D) immune globulin»

==General==
*Type: Immune Globulin
*Routes of Administration: IM, IV
*Common Trade Names: RhoGAM, WinRho

==Adult Dosing==
===[[Vaginal bleeding in pregnancy (less than 20wks)|1st Trimester (<12weeks) Vaginal Bleeding]]===
*Abortion or pregnancy loss (managed medically or surgically), ACOG now recommends '''no''' routine Rh testing or Rho(D) immune globulin prophylaxis.<ref>ACOG Clinical Practice Update: Rh D Immune Globulin Administration After Abortion or Pregnancy Loss at Less Than 12 Weeks of Gestation. Obstet Gynecol. 2024 Dec 1;144(6):e140-e143. doi: 10.1097/AOG.0000000000005733. Epub 2024 Sep 10. PMID: 39255498.</ref>
*Exceptions may include [[Trauma in pregnancy|trauma]] and [[ectopic]] (because the dataset does not include that population and the amount of fetomaternal hemorrhage and risk of alloimmunization is unknown)
**Dose is 50 microgm IM<ref>RhD alloimmunization: Prevention in pregnant and postpartum patients. Uptodate. Accessed 2/4/21</ref>
***There is no harm in giving the standard 300 microgram dose, which is more readily available

===[[Vaginal bleeding in pregnancy (greater than 20wks)|2nd & 3rd Trimester Vaginal Bleeding]]===
*300 microgm IM once and send Kleihauer-Betke test
**Within 72hrs give additional 300 microgm/15 ml Rh-positive blood

==Pediatric Dosing==
*Same as adult dosing above
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
**Animal studies have not been conducted, though available evidence suggest that administration of RhIG during pregnancy does not harm fetus<ref>ACOG practice bulletin. Prevention of Rh D alloimmunization. Number 4, May 1999 (replaces educational bulletin Number 147, October 1990). Clinical management guidelines for obstetrician-gynecologists. American College of Obstetrics and Gynecology. Int J Gynaecol Obstet. 1999; 66(1):63-70. [PubMed 10458556]</ref>
*[[Lactation risk categories|Lactation risk]]: 
**Caution advised while breastfeeding, however no adverse events observed
*Renal Dosing
**No dosage adjustments
*Hepatic Dosing
**No dosage adjustments

==Indications==
*For <b> risk</b> of fetal maternal hemorrhage, such as blunt abdominal trauma
*Risk = >4-12wks
*Duration effect: 12wks
*Also given to Rh- male trauma patients who receive O+ blood to prevent future reaction with O+ transfusions<ref>Miraflor, E, et al. Emergency uncrossmatched transfusion effect on blood type alloantibodies. J Trauma. 2012; 72:48-53.</ref>

==Contraindications==
*Allergy to class/drug
*Prior sensitization of mother
*Known Rh-negative father
*Known Rh-negative fetus (from cord blood)

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*Viral transmission risk
*Acute intravascular hemolysis in patients with [[ITP]]
*[[Acute transfusion reaction]]
===Common===
*Fever
*Injection site reaction
*Headache
*Myalgias
*Fatigue

==Pharmacology==
*Half-life: Approximately 30 days
*Metabolism: Unknown
*Excretion: Unknown
*Mechanism of Action: 
**Exact mechanism unknown
**Prevents isoimmunization by suppressing immune response by Rh negative individuals against Rh positive blood cells

==Comments==

==See Also==
*[[Vaginal Bleeding (Main)]]

==External Links==
*https://www.fda.gov/media/75013/download

==References==
<references/>
[[Category:Pharmacology]]
[[Category:OBGYN]]